Medication route refers to the way the drug is introduced into the body.

Permissible Routes

DFPS or SSCC staff members who are not licensed health care providers may administer medications and assist older children in taking medications by the following routes:

• Capsules, pills, or liquids taken by mouth.
• Inhalers taken through the nose or mouth.
• Eye drops.
• Skin patches.
• Nebulizers.

Non-Permissible Routes

DFPS or SSCC staff members who are not licensed health care providers may not administer medications by the following routes:

• Injection.
• Suppositories or creams taken through the rectum or vagina.
• Indwelling IV.
• Nasogastric tube (NG-tube).
• Gastrostomy tube (G-tube or G-button).

If a child is prescribed a medication to be administered in a way that is not approved for a DFPS or SSCC staff member (such as an NG-tube or injection) or a DFPS or SSCC staff member has questions, the DFPS or SSCC staff member contacts the child’s health care provider or calls STAR Health at 1-866-912-6283 for help. CPS nurse consultants may be able to provide general guidance but cannot provide direct assistance with medication administration.

Insulin

If an older child has approval by their medical provider to administer their own insulin injections, then DFPS or SSCC staff may supervise this administration. DFPS or SSCC staff members who are not licensed health care providers may not supervise insulin administration by children who are still learning to administer their own insulin and need guidance on technique.

Suppositories

If an older child is prescribed and understands how to insert a suppository or cream that is administered through the rectum or vagina, DFPS or SSCC staff may hand the medication to the child for the child to insert. DFPS or SSCC staff members who are the same gender as the child may stand outside the door of the bathroom while the child inserts the medication. However, DFPS or SSCC employees must not directly assist the child in inserting the medication into the child’s rectum or vagina.

Exception: Rectal Antiseizure Drugs for Emergencies

Children with seizure disorders can experience life-threatening prolonged seizures (status epilepticus) and may be prescribed rectal antiseizure medication for such emergencies. Emergency medical services (911) must be called for a prolonged seizure (typically longer than five minutes).

For children who are in the care of DFPS or SSCC staff, who may experience life-threatening status epilepticus (prolonged seizure), and who are prescribed rectal antiseizure drugs for emergencies, DFPS or SSCC staff must follow the instructions on the package insert to administer the rectal antiseizure drug as indicated by the prescription.

Exception: Epinephrine Auto-Injectors for Emergencies

Epinephrine auto-injectors are used for life-threatening allergic reactions and for children who are at increased risk for these reactions. Immediate emergency medical help (911) must be sought whenever an epinephrine auto-injector is administered.

For children who are in the care of DFPS or SSCC staff, who may experience life-threatening allergic reactions (anaphylaxis), and who are prescribed epinephrine auto-injectors, DFPS or SSCC staff must follow the printed, easy-to-follow instructions and diagram to administer this drug in the event of a severe allergic reaction. A severe allergic reaction can be characterized by the following:

• Skin reactions such as hives or itching.
• Difficulty breathing.
• Low blood pressure.
• Weak pulse.
• Vomiting.
• Diarrhea.
• Dizziness.
• Fainting.

Exception: Glucagon Administration for Diabetic Low Blood Sugar (Hypoglycemia) Emergencies

DFPS or SSCC staff must immediately administer a Glucagon emergency kit for a child who meets all of the following criteria:

• The child is in the care of DFPS or SSCC staff.
• The child is experiencing a life-threatening diabetic low blood sugar (hypoglycemia) emergency.
• The child has passed out or appears to be at immediate risk of passing out.
• The child cannot take some form of sugar by mouth.
• The child is prescribed a Glucagon emergency kit.

DFPS or SSCC staff must follow the prescription or kit instructions. Emergency medical services (911) must also be called immediately.